Ediberto Dejesus Garcia, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

TP652 Issued in KY

Practice address

200 Clinic Dr
Madisonville, KY 42431-1661

Phone

(270) 825-7351

Fax

(270) 825-6630

NPI assigned

Nov 13, 2006

Last updated

Jan 17, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: egarcia6866@bhkydirect.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421452800000",
    "number": "1598836314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950248",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950248",
            "telephone_number": "502-489-5730",
            "fax_number": "502-489-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CLINIC DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311661",
            "telephone_number": "270-825-7351",
            "fax_number": "270-825-6630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "EDIBERTO",
        "middle_name": "DEJESUS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2015-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101240450",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "KY",
            "license": "TP652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Gabbard
• Judy Riadon Gallagher, RPH
• Thomas A. Gallo, MD
• Abraham S. Galloway, MD
• Kristie Kay Gamble, CRNA
• Kaitlin Brooke Garrett, APRN
• Keri Garrett
• Shellie Gary-Cheirs, LPCC
• Benjamin Gatlin, PHARMD
• Melissa Gatlin

• General Practice Physician in Madisonville, KY
• Providers in Madisonville, KY by specialty
• General Practice Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.